TY - JOUR
T1 - Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry
AU - Min, Jeff
AU - Feng, Rui
AU - Badesch, David
AU - Berman-Rosenzweig, Erika
AU - Burger, Charles
AU - Chakinala, Murali
AU - De Marco, Teresa
AU - Feldman, Jeremy
AU - Hemnes, Anna
AU - Horn, Evelyn M.
AU - Lammi, Matthew
AU - Mathai, Stephen
AU - McConnell, John W.
AU - Presberg, Kenneth
AU - Robinson, Jeffrey
AU - Sager, Jeffrey
AU - Shlobin, Oksana
AU - Simon, Marc
AU - Thenappan, Thenappan
AU - Ventetuolo, Corey
AU - Al-Naamani, Nadine
N1 - Publisher Copyright:
© 2021 by the American Thoracic Society.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - RATIONALE: Obesity is associated with pulmonary arterial hypertension (PAH), but its impact on outcomes such as health-related quality of life (HRQoL), hospitalizations and survival is not well understood.OBJECTIVES: To assess the effect of obesity on health-related quality of life (HRQoL), hospitalizations and survival in patients with PAH.METHODS: We performed a cohort study of adults with PAH from the Pulmonary Hypertension Association Registry, a prospective multicenter registry. Multivariate linear mixed effects regression was used to examine the relationship between weight categories and HRQoL using the Short Form-12 (SF-12) and emPHasis-10 (e10). We used multivariable negative binomial regression to estimate hospitalization incidence rate ratios (IRRs) and Cox regression to estimate hazard ratios (HRs) for transplant-free survival by weight status.RESULTS: 767 subjects were included: mean age of 57 years, 74% female, 33% overweight and 40% obese, with median follow-up duration of 527 days. Overweight and obese patients had higher baseline e10 scores (worse HRQoL), which persisted over time (p<0.001). The overweight and obese have a trend towards increased incidence of hospitalizations compared to normal weight (IRR 1.34, 95% confidence interval (95%CI) 0.94-1.92 and 1.33, 95%CI 0.93-1.89, respectively). Overweight and obese patients had lower risk of transplant or death as compared to normal weight patients (HR 0.45, 95%CI 0.25-0.80 and 0.39, 95%CI 0.22-0.70, respectively).CONCLUSIONS: In a large multicenter, prospective cohort of PAH, overweight and obese patients had worse disease-specific HRQoL despite better transplant-free survival compared to normal weight patients. Future interventions should address the specific needs of these patients.
AB - RATIONALE: Obesity is associated with pulmonary arterial hypertension (PAH), but its impact on outcomes such as health-related quality of life (HRQoL), hospitalizations and survival is not well understood.OBJECTIVES: To assess the effect of obesity on health-related quality of life (HRQoL), hospitalizations and survival in patients with PAH.METHODS: We performed a cohort study of adults with PAH from the Pulmonary Hypertension Association Registry, a prospective multicenter registry. Multivariate linear mixed effects regression was used to examine the relationship between weight categories and HRQoL using the Short Form-12 (SF-12) and emPHasis-10 (e10). We used multivariable negative binomial regression to estimate hospitalization incidence rate ratios (IRRs) and Cox regression to estimate hazard ratios (HRs) for transplant-free survival by weight status.RESULTS: 767 subjects were included: mean age of 57 years, 74% female, 33% overweight and 40% obese, with median follow-up duration of 527 days. Overweight and obese patients had higher baseline e10 scores (worse HRQoL), which persisted over time (p<0.001). The overweight and obese have a trend towards increased incidence of hospitalizations compared to normal weight (IRR 1.34, 95% confidence interval (95%CI) 0.94-1.92 and 1.33, 95%CI 0.93-1.89, respectively). Overweight and obese patients had lower risk of transplant or death as compared to normal weight patients (HR 0.45, 95%CI 0.25-0.80 and 0.39, 95%CI 0.22-0.70, respectively).CONCLUSIONS: In a large multicenter, prospective cohort of PAH, overweight and obese patients had worse disease-specific HRQoL despite better transplant-free survival compared to normal weight patients. Future interventions should address the specific needs of these patients.
KW - Hospitalization
KW - Obesity
KW - Pulmonary arterial hypertension
KW - Quality of life
KW - Survival analysis
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U2 - 10.1513/annalsats.202006-612oc
DO - 10.1513/annalsats.202006-612oc
M3 - Article
C2 - 33085915
AN - SCOPUS:85101173936
SN - 2329-6933
VL - 18
SP - 229
EP - 237
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 2
ER -